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Hospice To Repay $10M for Overbilling

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
Wikimedia Commons
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Covenant Hospice Inc., a non-profit hospice care provider in Southern Alabama and Northwest Florida, will pay more than $10.1 million to the government for overbilling of Medicare, Tricare and Medicaid for hospice services, the Northwest Florida Daily News reports.

The claims occurred between Jan. 1, 2009, and Dec. 31, 2010 for hospice claims for general inpatient care that should have been billed at the routine home care level for patients,according to the Daily News

In Bradenton, the operators of the Suncoast Brace & Limb orthopedic brace and prosthetics company, pleaded guilty to $1.4 million in Medicare and Medicaid claims for prosthetic devices, The Tampa Tribune reports.The company, which does business in south Hillsborough, Manatee, Sarasota and Citrus counties, submitted the claims  from July 2009 to March 2012, according to The Tribune. They may also have to pay a $500,000 fine.
Meanwhile, an Auburndale clinic owner, Dr. Douglas Price, is being charged with three counts of patient brokering, a third-degree felony, The Ledgerof Lakeland reports. It’s part of what authorities say is a scheme to recruit patients for treatment of fake injuries following staged accidents.
Price owns the Florida Pain Trauma and Injury Clinic, which has locations in Auburndale and Tampa. His employees, Paulin Sanon and Sonya Rivera of Haines City, are charged with one count each of patient brokering, and Juliena Julien of Winter Haven, is being charged with unlicensed practice of health care, the Ledger reports.
And and Vero Beach, a surgeon and a plastic surgery clinic will pay $4 million to resolve allegations that Medicare was billed for procedures that were unnecessary or never occurred, the Associated Press reports. 
Dr. Donald C. Proctor Jr. also agreed under the False Claims Act settlement not to participate in the Medicare or Medicaid programs for at least five years. Proctor runs the Grove Place Surgery Center in Vero Beach.

Mary Shedden is news director at WUSF.